Clinical outcome of dexmedetomidine in awake anesthesia for craniotomy

Luan Hanlin; He Huan; Tu Weifeng

doi:10.11850/j.issn.1009-122X.2017.07.011

Abstract：Objective To investigate the clinical outcome of diffenent dosages of dexmedetomidine in awake anesthesia for craniotomy. Methods Sixty patients undergoing eloquent area operation with intraoperative awakening were randomly and equally divided into low dose group, middle dose group and high dose group. All the patients were given dose of 1 μg/kg dexmedetomidine 10 min before induction anesthesia, followed by 1 μg/kg fentanyl via intravenous administration and target conrolled infusion of proporol until the patients getting into the loss of consciousness and the Narcotrend trend of D2 to E0. Then the laryngeal mask was inserted. A continuous infusion of 0.2, 0.4, and 0.6μg/ (kg?h) dexmedetomidine via intravenous pumping was performed on patients in low, middle and high dose groups respectively. The intravenous pumping of proporol was stopped after the exposure of dura mater to make patients keep awake during the functional localization and operation. The hemodynamic changes, awakening time and adverse reaction in different time points were analyzed and compared to estimate the awakening quality of patients in the 3 groups. Results The heart rate of high dose group was lower than that of low and middle dose groups at the time of laryngeal mask insertion and the time of skin incision (P<0.05). Compared with patients in high dose group, the patients in low and middle dose groups could be aroused in a shorter time (P<0.05). Conclusions Dexmedetomidine can be applied in awake surgery. The dose of 0.4μg/ (kg?h) dexmedetomidine can obtain the best awakening quality, which provides stable hemodynamics with no respiratory depression and shorter awakening time, and thus is a good anesthesia and sedation drug for awake surgery.